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bds 2 > perio aetiology > Flashcards

perio aetiology Flashcards

1
Q

What are local plaque retention factors? (4 points)

A
  • Calculus
  • Restoration margins
  • Crowding
  • Mouth breathing
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2
Q

What are systemic modifying factors for plaque/gingivitis? (2 points)

A

Sex hormones
Medication

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3
Q

What characteristics define gingival health? (3 points)

A
  • Knife edge, scalloped gingival margin
  • Stippling (in about 30%)
  • Pink
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4
Q

What are defining features of periodontitis? (2 points)

A

Irreversible loss of attachment of the epithelium
Low bone

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5
Q

Does gingivitis always progress to periodontitis?

A

no

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6
Q

Once periodontitis is initiated, is progression of the attachment loss episodic or continuous?

A
  • Can be either
  • Hard to judge how fast it goes once initiated
  • Different sites within the same mouth may be affected to markedly varying degrees
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7
Q

What is the rate of progression loss of attachment in periodontitis like?

A

Generally very slow (0.05-0.1mm per year) but this is highly variable

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8
Q

What is biofilm?

A

One or more communities of microorganisms, embedded in a glycocalyx, attached to a solid surface

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9
Q

What are 4 properties of biofilm?

A
  • Provide protection for colonising species from competing organisms and environment (host defences, antibiotics)
  • Facilitate uptake of nutrients and removal of metabolic products
  • Development of appropriate physiochemical environment e.g. pH, O2 concentration
  • Communication between bacteria
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10
Q

What 2 features can increase the bacteria’s virulence?

A

Ability to colonise and compete in an ecological niche
Ability to evade host defences

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11
Q

How can bacteria evade host defences? (4 points)

A
  • Degrade host immunoglobin and complement
  • Leukotoxin production
  • Tissue invasion
  • Inhibition of antibody synthesis
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12
Q

Does a specific bacteria cause periodontal disease?

A

Not one single bacteria has been proven causative

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13
Q

What is possible evidence needed to prove that a specific bacteria is the cause of something? (5 points)

A
  • Presence in elevated numbers at diseased sites
  • Reduced numbers following periodontal therapy
  • Presence of an elevated specific immune response
  • Production of virulence factors
  • Evidence from animal models
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14
Q

Which complex of bacteria makes you likely to have perio problems? (3 points)

A
  • P. gingivalis
  • B. forsythus
  • T. denticola
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15
Q

Can periodontitis occur without the presence of bacteria ?

A

No

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16
Q

Periodontitis is a synergistic infection. What does this mean?

A

Not just one bacteria that causes it (plaque ecology is important)

17
Q

What are examples of mechanisms that contribute to the host response against perio problems? (4 points)

A
  • Saliva
  • Epithelium (physical barrier, shedding of cells, production of inflammatory mediators)
  • GCF
  • Inflammatory and immune responses
18
Q

Which type of cell is the initial periodontal lesion composed of?

A

T lymphocytes

19
Q

The initial periodontal lesion is compromised mainly of T lymphocytes. Which cells predominate in a later stage? (2 points)

A

B cells
Plasma cells

20
Q

Antibody is produced locally at the initial periodontal lesion. What is its likely role?

A

Likely protective role

21
Q

What are the protective functions of an antibody? (4 points)

A
  • Inhibition of adhesion/invasion
  • Complement activation
  • Neutralisation of toxins
  • Opsonisation and phagocytosis
22
Q

What are MMP’s? (2 points)

A
  • Matrix metalloproteinases are a family of zinc and calcium dependent proteolytic enzymes, which include collagenases
  • In periodontitis, Matrix degradation is largely a result of MMP’s secreted by host inflammatory cells
23
Q

What are general risk factors of periodontitis? (6 points)

A

smoking
diabetes
stress
drugs
systemic disease
nutrition

24
Q

What are risk determinants of periodontal disease? (3 points)

A
  • Genetics
  • Socioeconomic status
  • Gender
25
Q

What are anatomical risk factors that can cause periodontitis? (4 points)

A
  • Enamel pearls/projections
  • Grooves
  • Furcations
  • Gingival recession
26
Q

What tooth positions are predisposed to perio problems? (5 points)

A
  • Malalignment
  • Crowding
  • Tipping
  • Migration
  • Occlusal forces
27
Q

What are iatrogenic risk factors for periodontitis? (4 points)

A
  • Restoration overhangs
  • Defective crown margins
  • Poorly designed partial dentures
  • Orthodontic appliances
28
Q

Why can smoking contribute to periodontitis? (5 points)

A
  • Vasoconstriction of gingival vessels and increased gingival keratinisation
  • Impaired antibody production
  • Depressed numbers of Th lymphocytes
  • Impaired PMN function
  • Increased production of pro-inflammatory cytokines
29
Q

What is the primary aetiological agent in inflammatory periodontal disease?

A

Microbial plaque

bds 2 (38 decks)

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